Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Aug 2007
Clinical staff resource use with intravenous patient-controlled analgesia in acute postoperative pain management: results from a multicenter, prospective, observational study.
The purpose of this study was to evaluate hospital resource utilization associated with intravenous patient-controlled analgesia (IV-PCA), with a focus on nursing, pharmacy, and central supply/engineering time spent from a hospital perspective. Data were collected during a multicenter (29 sites), prospective observational study in the United States of subjects who underwent total knee replacement (TKR), total hip replacement (THR), or abdominal hysterectomy (AH) and were administered analgesia through IV PCA for the management of acute postoperative pain. Nursing staff recorded the IV PCA-related tasks they performed for a subject and the duration of time required to perform each task from initial IV PCA set-up to discontinuation. ⋯ Intravenous patient-controlled analgesia postoperative care requires coordination and involvement of numerous hospital departments. It is labor intensive and involves numerous time-consuming tasks, oversight of IV PCA, and ongoing training. Alternative methods of patient-controlled pain management with similar efficacy that reduces labor resource utilization may be warranted.
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J. Perianesth. Nurs. · Aug 2007
Follow-up phone calls after pediatric ambulatory surgery for tonsillectomy: what can we learn from families?
The purpose of this quality improvement study was to describe families' responses regarding the adequacy of the preoperative preparation provided in the Preoperative Assessment Clinic, and the necessity of two follow-up phone calls after pediatric ambulatory surgery for tonsillectomy with or without adenoidectomy (T+/-A). Using a questionnaire developed for the study, 90 families were contacted by phone on the first postoperative day and, of them, 73 were contacted a second time between the ninth and twelfth postoperative days. Families' responses were reported in four categories: (1) concerns, (2) use of resources, (3) adequacy of the preoperative teaching, and (4) necessity of the two postoperative phone calls. ⋯ The most frequently consulted resource person for concerns was the physician on call for the otolaryngology service. Eighty-seven percent of families felt the preoperative preparation was adequate. For reasons of instructional and/or emotional support, 94% of families who responded reported that the first phone call was necessary and 68% reported that the second call was as well.
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Severe postoperative pain is common following orthopaedic surgery, and its safe and effective management can be challenging for everyone on the health care team. There are a variety of methods used to address orthopaedic postoperative pain and all incorporate the principles of multimodal analgesia. The purpose of this article is to provide an overview of the primary methods used to manage orthopaedic pain and describe the perianesthesia nurse's role in the administration of them.
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A multidisciplinary team was formed to look at consolidating and improving patient education for patients preparing to undergo total knee replacement or total hip replacement. The objective was to encompass disciplines from across the continuum of care, beginning with the surgeon's office through postdischarge rehabilitation. ⋯ This article describes how working together with all disciplines involved resulted in a consolidated order set, clinical and patient pathways that reflected actual care and processes, a user-friendly patient education book, and a multidisciplinary patient education class. The end products led to consistency in the quality of care across the continuum from preadmission through postdischarge rehabilitation for total joint replacement patients.